Letters of Medical Necessity

We provide templates for Letters of Medical Necessity for you to send to your home medical supplier alongside your prescription. Find the appropriate template for your formula below.

Letter of Medical Necessity

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Get Formula for Medical Use

Medical formulas can be used at home, in a hospital, or in a skilled nursing facility.

Insurance Coverage

You may be able to get your formula through a home medical supplier.

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Navigate your insurance and next steps, or get service for online orders.

Request Samples

We send samples at the request of your healthcare provider.

Letters of Medical Necessity

Standard 1.0

Standard 1.4

Peptide 1.0

Peptide 1.5

Pediatric Standard 1.2

Pediatric Peptide 1.0

Pediatric Peptide 1.5

Glucose Support 1.2

Renal Support 1.8

Pediatric Blended Meals

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